Faisal M. Nimri, MD1, Maher Musleh, DO2, Yara Dababneh, MD3, Aroob Sweidan, MD3, Omar Shamaa, MD3, Mallory Brosious, MD3, Diana Jomaa, MD3, Mouhanna Abu Ghanimeh, MD2, Tobias Zuchelli, MD3 1Henry Ford Hospital, Troy, MI; 2Henry Ford Health System, Detroit, MI; 3Henry Ford Hospital, Detroit, MI
Introduction: Chronic pancreatitis (CP) is a progressive fibroinflammatory disease resulting in a permanent structural damage in the pancreas. The incidence of CP in the US is around 4-14/100,000 with alcohol being the most common cause. CP can lead to abdominal pain, exocrine and endocrine dysfunction and cause significant impairment in quality of life. Recurrent presentations to the ED due to CP symptoms can impact healthcare expenditures and lead to challenges in treating these patients. Our study looks at factors affecting follow-up rates in clinics after presenting to the ED from abdominal pain.
Methods: A retrospective single-center study was conducted at a large tertiary health care system in Detroit, MI. Patients 18 years of age and older who presented to the ED for Abd pain with CP from 2018 to 2020 were included. Data on demographics, ED dynamics, and follow-up were collected with a manual chart review. We used the social deprivation index (SDI) score associated with different zip codes to compare patients’ socio-economic status (SES).
Results: A total of 196 patients were included (mean age 49.6 years, SD 11.7), of which 117 (59.7%) were males and 102 (52.6%) were Caucasians. 141 (71.9%) patients developed CP due to alcohol. Univariate analysis showed that women followed up in the clinic more than men (p=0.027). Caucasians followed up more than African Americans, Asian, Hispanic, and other races combined (p< 0.0001). Patients living in Wayne County lower (low-middle SDI score) followed up more than others living in the surrounding counties (high SDI score) (p=0.049). Alcohol-induced CP patients followed up more than other etiologies (p=0.049) and patients in lower SDI score counties followed up more than those in higher scores (p=0.003). Patients who were arranged a primary care physician (PCP) or GI clinic follow-up on discharge from the ED followed up more than those who were hospitalized. There was no significant difference regarding follow-up rates and age, ED presentation frequency, tobacco use, narcotic use, and those that underwent imaging.
Discussion: Women, Caucasians, and low-middle SES (lower SDI scores) followed up more than men, other races, and those with higher SES (higher SDI scores). Interestingly, regardless of the follow-up rates, ED visitations were not significant amongst groups suggesting that more complex factors account for CP patient’s presentation to the ED. Further studies are needed to improve factors that affect follow-up rates and overcome any barriers.
Disclosures: Faisal Nimri indicated no relevant financial relationships. Maher Musleh indicated no relevant financial relationships. Yara Dababneh indicated no relevant financial relationships. Aroob Sweidan indicated no relevant financial relationships. Omar Shamaa indicated no relevant financial relationships. Mallory Brosious indicated no relevant financial relationships. Diana Jomaa indicated no relevant financial relationships. Mouhanna Abu Ghanimeh indicated no relevant financial relationships. Tobias Zuchelli indicated no relevant financial relationships.
Faisal M. Nimri, MD1, Maher Musleh, DO2, Yara Dababneh, MD3, Aroob Sweidan, MD3, Omar Shamaa, MD3, Mallory Brosious, MD3, Diana Jomaa, MD3, Mouhanna Abu Ghanimeh, MD2, Tobias Zuchelli, MD3. P0029 - Factors That Influence Follow-Up for Patients With Chronic Pancreatitis After Presentation to the ED With Abdominal Pain, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.